Basic Information
| Provider Information | |||||||||
| NPI: | 1295719425 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCDOWELL | ||||||||
| FirstName: | JASON | ||||||||
| MiddleName: | ARTHUR | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1702 BRIAN WILLIAM RD | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282127603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7045772899 | ||||||||
| FaxNumber: | 7043663233 | ||||||||
| Practice Location | |||||||||
| Address1: | 4421 SHARON RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282115585 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043663220 | ||||||||
| FaxNumber: | 7043663233 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2005 | ||||||||
| LastUpdateDate: | 01/04/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251X0800X | 9120 | NC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
No ID Information.